Clinical Research On Correlation Of Dyslipidemia And Coagulopathy With The Phlegm Syndrome And Blood Stasis Syndrome NSCLC Patients

Objective:This study was a retrospective clinical study to observe the phlegm, blood stasis, phlegm syndrome in patients with non-small cell lung cancer lipids and coagulation dysfunction correlation, non-small cell lung cancer treatment-related factors and blood test indicators relationship summary Chinese characteristics and advantages for in-depth study of TCM type of lung cancer and in combination therapy to provide effective ideas and methods.Methods:This study collected medical records Guang An Men Hospital of Traditional Chinese Academy of Oncology primary non-small cell lung cancer, the use of "structured collection of traditional Chinese medicine hospital medical records system," met the inclusion criteria were 134 cases of information received, all the data tables overall verification and verification of the total number of sample cases, improve patient in the hospital during the circumstances surrounding the case, and randomly selected sample verification; data processing unified standard terms, terminology and format. Use of computer technology to the common symptoms of all cases, tongue and pulse were determined syndromes, TCM determine type of non-small cell lung cancer, were frequency analysis, and to investigate its evolution. Using SPSS 19.0 statistical package for statistical analysis, measurement data using mean ± standard deviation described, in line with normal or near normal distribution between the two groups were compared using t-test among groups were compared using analysis of variance, pairwise comparison using LSD test; do not meet the normal or near normal distribution between groups were compared using rank sum test. Count (higher or lower in patients with physical and chemical indicators of frequency) data between groups were compared using chi-square test or Fisher’s exact test, with P<0.05 was considered statistically significant, explore TCM and clinical diagnosis and treatment factors, between the physical and chemical indicators relationship.Results:1.Analysis of sputum, phlegm and blood stasis type NSCLC TCM SyndromesThe case study sample of syndromes are:phlegm syndrome in 33 cases,36 cases of blood stasis syndrome, phlegm syndrome 65 cases of phlegm and blood stasis syndrome approximate proportion, phlegm syndrome larger proportion Phlegm syndrome main syndromes of phlegm and phlegm, associated with lung and spleen deficiency, kidney deficiency and blood deficiency and Qi. Blood Stasis Syndrome and main qi deficiency, qi stagnation and blood deficiency, kidney deficiency. Phlegm syndrome and major certified as Qi.2.Phlegm, blood stasis and phlegm type of non-small cell lung cancer Syndrome Type and blood lipids, coagulation relevanceThree groups of four patients with serum lipids syndromes are different proportions of abnormalities, including phlegm syndrome group, triglyceride (TG) in 15 cases of high (45% of the total phlegm syndrome group), which constitutes more than Stasis certificate 4 cases (11% of the total BSS group) and 21 patients with phlegm (phlegm group accounted for 32% of the total), which constitutes more than statistically significant difference (P<0.05). High-density lipoprotein (HDL) appears to reduce the case, which reduces the number of cases of phlegm syndrome constituent ratio were 19 cases (57.6%), BSS group seven cases (19%), phlegm group of 34 patients (52.3%), phlegm syndrome and phlegm syndrome group, reduce the proportion of approximation, are higher than the BSS group, the difference was statistically significant (P<0.05). Three groups of patients with total cholesterol (TC) higher than the number of cases constitute were 7 cases (21%) phlegm syndrome group, blood stasis syndrome group 3 patients (8.3%), phlegm group of 12 patients (18.5%). but the difference was not statistically significant (P> 0.05); low-density lipoprotein (LDL) higher than the number of cases constitute phlegm syndrome were 10 patients (30.3%).6 cases of BSS group (17%), phlegm stasis in each node group.18 patients (27.7%), but the difference was not statistically significant (P> 0.05). Three kinds of syndromes of lung cancer patients serum lipids variance analysis after three syndromes lipid levels:phlegm syndrome group, triglyceride (TG) levels, higher blood stasis and phlegm syndrome group, but the difference was not statistically significant (P> 0.05).Three groups of patients with the syndrome of coagulation indicators, D-dimer quantification (DD), fibrinogen (FIB), activated partial thromboplastin time (APTT), hematocrit (HCT) in varying proportions exception in which three groups of patients quantitative D-dimer (DD) and fibrinogen (FIB) were elevated ratio of approximately 40% or more, and activated partial thromboplastin time (APTT) and hematocrit (HCT) among the three groups significant statistical difference. Activated partial thromboplastin time (APTT) phlegm group of 41 cases decreased (63%), reduced blood stasis group,21 patients (58%), phlegm syndrome group,12 cases decreased (36%), by chi-square after the test found phlegm group activated partial thromboplastin time (APTT) reduce significantly higher than stasis syndrome cases higher than phlegm syndrome group (P<0.05); compared with the other two groups, the phlegm group hematocrit (HCT) the high number of cases to 46 cases (70%), higher than the number of cases of high blood stasis group,21 cases (58%), higher than the high number of cases of phlegm syndrome group and 17 cases (51%), the difference was statistically significant (P<0.05). Three kinds of syndromes of lung cancer patients with coagulation index variance analysis found, phlegm syndrome group of activated partial thromboplastin time (APTT) was significantly lower than stasis syndrome group than in phlegm syndrome group (P<0.01).3.Phlegm, blood stasis and phlegm type associated non-small cell lung cancer patients with clinical factors and TCM SyndromesIn this study, the clinical phases of phlegm, blood stasis and phlegm differences (P<0.05) syndrome type distribution in which phase Ⅰ, Ⅱ and Ⅲ phlegm syndromes higher proportion, while stage Ⅳ phlegm syndromes decline in the proportion, the ratio between the syndrome candidate closer. Histological type, primary tumor surgery cases, metastasis, and chemotherapy with non-small cell lung cancer demonstrated by phlegm, blood stasis, phlegm syndrome distribution no significant correlation (P> 0.05).4.Phlegm, blood stasis and phlegm type of clinical treatment of non-small cell lung cancer patients with lipid-related factors, coagulation relevance4.1 Clinical stage and lipids, coagulation relevance:High-density lipoprotein (HDL) reduce the situation is different in various clinical stages distribution:IV Reduce the situation was significantly higher than the other three groups (P<0.05); Serum Lipids in the clinical stage no significant difference between (P> 0.05). Hematocrit (HCT) in various clinical stages distribution of difference:where the high number of cases II and IV was significantly higher than the other two groups (P<0.05).4.2 Pathology and blood lipid, coagulation Dependency:Adenocarcinoma triglyceride (TG) was significantly higher than the high cases of squamous cell carcinoma group (P<0.05), other lipid parameters between the two groups showed no significant difference (P> 0.05); adenocarcinoma triglyceride (TG) index significantly higher than squamous cell carcinoma (P <0.05), the other three lipid parameters between the two groups showed no significant difference (P> 0.05). Squamous cell carcinoma hematocrit (HCT) High case were higher than adenocarcinoma (P<0.05), other coagulation parameters between the two groups showed no significant difference (P> 0.05); squamous cell carcinoma patients prothrombin time (PT) and activated partial thromboplastin time (APTT) higher than adenocarcinoma (P<0.05). and adenocarcinoma hematocrit (HCT) higher than squamous cell carcinoma (P<0.05). other coagulation indicators There was no significant difference between the two groups (P> 0.05).4.3 Primary tumor surgery cases and blood lipids, coagulation relevance:Case studies of coagulation and primary lung lesion relations surgery cases were compared, after t test, patients without surgery hematocrit (HCT) is higher than after surgery (P<0.05), other groups in coagulation no statistically significant difference between (P> 0.05).4.4Cases of lung cancer metastasis and blood lipids, coagulation index Dependency:It has been transferred group fibrinogen (FIB) High case detection rate was significantly higher than that without metastasis (P<0.05); in hematocrit (HCT) connection, the case has been transferred group significantly higher than the high metastasis group (P< 0.05); at the same time, has been transferred hematocrit (HCT) were higher than those without metastasis (P<0.05), other coagulation parameters between the two groups showed no significant difference (P> 0.05)4.5 Chemotherapy and blood lipids, coagulation index Dependency:After chemotherapy triglyceride (TG) High case is not lower than the chemotherapy group (P<0.05). Chemotherapy group activated partial thromboplastin time (APTT) reduction will not lower than the chemotherapy group (P<0.05), chemotherapy group activated D-dimer (DD) rise from below the no chemotherapy group (P<0.05), in red blood cells hematocrit (HCT) aspects of the chemotherapy group was significantly lower than the high case chemotherapy group (P<0.05); two groups were compared at the same time coagulation, after t test showed that chemotherapy patients activated partial thromboplastin time (APTT) high for without chemotherapy (P<0.05).Conclusion:The results of this study showed that non-small cell lung cancer patients lipid levels and blood clotting abnormalities and lung phlegm, blood stasis, phlegm syndromes in direct contact with patients with clinical stage, histologic type, tumor surgery, the tumor metastasis there is a certain correlation and chemotherapy. Lipid levels and blood clotting function may reflect the presence and severity of three kinds of basic TCM syndromes in patients with lung cancer, so we can put the estimated blood lipid levels and blood clotting function as a determination of lung cancer syndromes physicochemical basis, in order to enrich the diagnostic criteria of syndrome type. Pathogenesis of lung cancer patients have the diversity and complexity of features, which, stasis, phlegm, deficiency is the main pathological basis, mutual conversion between Phlegm and mutual pump knot is an important stage of tumor development. So for the diagnosis and treatment of lung cancer patients, should seize both the symptoms and specific physical and chemical examination indicators have dialectical sense, given that most advanced stage lung cancer patients to the hospital of Chinese medicine treatment, the treatment should pay attention to the characteristics of the pathogenesis of lung cancer, attention stasis, phlegm, virtual relationships, pay attention to righting, phlegm, blood stasis and other combination therapy, taking care with lipid-lowering, anticoagulant therapy according to the clinical condition of the patient, in order to receive better clinical efficacy.